Earthquake: The Long Road Back : Army of Counselors Help Doctors, Nurses Cope : Stress: Battle-weary health workers need ways to relieve their own quake anxiety.

If Gen. H. Norman Schwarzkopf had been a psychiatrist, he might have been like Dr. Stephen E. Salenger.

Clad in army fatigues and black combat boots, the husky, bearded Salenger prowls the halls of Northridge Hospital Medical Center, pausing to talk with haggard-looking doctors and nurses, offering them words of solace and encouragement as if they were battle-weary soldiers headed back to the front line.

Which, in a sense, they are.

Since Monday’s shattering earthquake, Los Angeles hospitals have treated and released 6,547 injured people. Another 1,292 were admitted with serious injuries, and many of them are in critical condition.

That huge influx of patients, combined with the frustration of broken equipment and the tension of 14-hour days, has left many hospital workers exhausted to the point of burnout.

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At several hospitals, psychiatric counselors have swung into action, advising staffers on how to cope with the stresses of caring for hordes of injured people as they struggle to clean up their own homes and reassure frazzled families.

At Kaiser Permanente in Panorama City, a counselor met with employees of the optometry department to discuss their emotions after their popular department head, Burton Krell, was killed in an auto accident while heading for the hospital shortly after the quake struck.

At Cedars-Sinai Medical Center on the Westside, a psychiatrist sent one employee home after she expressed terror that she would be swallowed by ground softened because of repeated aftershocks.

Just minutes into a quake-stress meeting at the Northridge hospital, located virtually atop the quake’s epicenter, a middle-aged nurse stood and walked swiftly from the room. Returning later, she said she had thrown up--a reaction to days of trying to suppress fear of the quake and its aftershocks.

“I’ve been acting braver than I really am,” she said. “Suddenly just now I felt this awful nausea. I thought I was doing quite well until that point.”

At the same meeting, a young emergency room technician expressed shame over not rushing to the hospital right after the quake; a top executive said he was angry at political “looky-loos”--including Gayle Wilson, Gov. Pete Wilson’s wife--for appearing at the overloaded hospital for photo-opportunities.

Northridge officials acknowledge that day after day of 12- and 14-hour shifts--combined with worries about quake-damaged homes and anxious spouses and children--are wearing down staffers.

“It’s a massive amount of psychic trauma around here--it’s not letting up,” said Dr. Paul Karis, who supervises the emergency room staff at Northridge, which has treated more than 600 quake victims since Monday. “The staff is just running out of steam.”

Karis told of approaching another Northridge doctor a couple of days after the quake to ask how he was holding up.

The doctor erupted into tears.

“He’s the first person you see in the morning . . . and he says he has several patients with chest pains, one with a heart attack. His house is basically condemned, he hasn’t slept more than six hours in the past three days,” Karis said.

“His wife is coming apart, his kids won’t stop crying. His brick wall fell down, and the dogs ran away.”

Some hospitals also have set up day-care centers for employees whose regular day-care arrangements were canceled or who simply cannot bear to be separated from their children at the moment--or vice versa.

To help stressed-out staffers at Northridge, Salenger, the psychiatrist, and three dozen other doctors, nurses and emergency workers were brought in under a little-known federal program, the National Disaster Medical System, which dispatches teams of medical workers to backup local ones that are overwhelmed during major disasters.

Salenger’s team, which also responded in Hawaii after Hurricane Iniki, wears distinctive blue jumpsuits or military fatigues; many members also wear combat boots. Most of them work at hospitals and fire departments in San Bernardino County.

Striding the corridors at Northridge in his camouflage combat outfit, Salenger, chief of staff at Patton State Hospital, a psychiatric facility in San Bernardino, sought to reassure anxiety-ridden staffers that their reactions were nothing to worry about.

“These are not psychological problems,” he said. “This is not mental illness. These are normal reactions to abnormal situations.”

Salenger described their problems as “critical incident stress,” saying the best treatment is simply to give workers a chance to vent their feelings and fears--while on the job.

Although temporary, the stress can develop, if untreated, into far more serious post-traumatic stress disorder, a mental disturbance suffered by some Vietnam War veterans.